AVERA MCKENNAN NPI 1033185582

NPI Information

NPI: 1033185582
Provider Name: AVERA MCKENNAN

Doing Business As: AVERA MEDICAL GROUP ONCOLOGY AND HEMATOLOGY SIOUX FALLS

Classification: Internal Medicine - 207RH0003X
Entity Type: Organization

Specialization: Hematology & Oncology

Address:
1000 E. 23RD ST.
STE. 230
SIOUX FALLS, SD
ZIP 57105
Phone: (605) 322-6900
Get Directions

AVERA MCKENNAN is a hematology and oncology internal medicine in Sioux Falls, SD. The provider is an internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. AVERA MCKENNAN NPI is 1033185582. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Avera Medical Group Oncology And Hematology Sioux Falls.

The provider's business location address is:

1000 E. 23RD ST.
STE. 230
SIOUX FALLS, SD
ZIP 57105-122
Phone: (605) 322-6900
Fax: (605) 322-6901

The provider's authorized official is David Flicek .
The authorized official title is Ceo/president and has the following contact phone number (605) 322-8000.

The enumeration date for this NPI number is 2/24/2006 and was last updated on 11/21/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207RH0003X	Internal Medicine	Hematology & Oncology			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0040098	OTHER	SOUTH DAKOTA	BCBS
2	0555797	MEDICAID	IOWA
3	370S8ME	OTHER	MINNESOTA	BCBS
4	185582400	MEDICAID	MINNESOTA
5	370S8ME	OTHER	MINNESOTA	BLUE PLUS
6	125K2ME	OTHER	MINNESOTA	BCBS IN MN
7	370624200	OTHER	SOUTH DAKOTA	DEPT OF LABOR
8	92411422903	OTHER	MINNESOTA	PRIMEWEST
9	83314	OTHER	SOUTH DAKOTA	HEALTHPARTNERS
10	9201852	OTHER	SOUTH DAKOTA	DAKOTACARE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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